Elevated Mood Flashcards
When is elevated mood pathological?
In combination with other signs/symptoms
What are the characteristics of mania?
Elevated mood Increased energy Overactivity Pressure of speech Decreased need for sleep Disinhibition Distractability Inflated self esteem Grandiose ideas Taking risks Overspending Perceptual disturbance Irritability/suspicion
Describe hypomania
No psychosis Increased energy and activity Same symptoms as mania, but milder Sometimes irritability Some disturbance of function Feelings of wellbeing and efficiency Mild mood elevation
What are the key differences between mania and hypomania?
Mania will likely impact function
If in hospital due to elevated mood: mania
What is bipolar affective disorder?
Two or more episodes mania +- depression (hypomania for bipolar 11)
Describe mania with psychotic symptoms
Mood congruent delusions- often grandiose, religious, suspicious Mood congruent hallucinations Mood incongruent symptoms Also associated with Flight of ideas, incomprehensible speech Severe sustained physical activity Aggressive behaviour Self neglect, dehydration
What is rapid cycling?
4 or more mood episodes in one year
May be interspersed with periods of wellness
Cycling may take place in a matter of days, weeks or months
What are the mood states at time of suicide in patients with bipolar affective disorder (highest to lowest)?
Depression
Manic/mixed (equal)
What is the M:F ratio of bipolar affective disorder?
1:1
What is the mean age of onset of bipolar affective disorder?
21yo
What is the prevalence of Bipolar 1 and 2 respectively?
1 and 1.5-5%
What is the aetiology of bipolar affective disorder?
Individual vulnerability factors: Genetics- 1st degree relatives 7 fold risk -Child 50% risk psych disorder -Monozygotic twins 33-90% Environment has less impact Current factors: -Stressors/life events -Sleep deprivation -Childbirth -Physical Illness -Drugs
What is the median length of untreated BAD episodes?
3 months
What are the organic differentials in suspected BAD?
Neurological eg brain tumour Endocrine eg hyperthyroidism Inflammatory eg SLE Infection eg neurosyphilis Sleep disorders eg sleep deprivation, circadian rhythm disorders Medication eg steroids Drugs eg dexamphetamine (speed)
What is the psychiatric ddx in BAD?
Schizoaffective disorder
Cyclothymia
ADHD
Emotionally unstable personality disorder
